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I am about 2 months into the program, my insurance requires 6 months and 11 office visits, at least 18 years old, and bmi 40 and had to have been over 40 for 2 years. Has anyone else gone through the whole program and met all the requirements and gotten denied by this insurance? I would be so disappointed! And ive seen posts with other insurances doing that so i was wondering about mine!

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I am about 2 months into the program, my insurance requires 6 months and 11 office visits, at least 18 years old, and bmi 40 and had to have been over 40 for 2 years. Has anyone else gone through the whole program and met all the requirements and gotten denied by this insurance? I would be so disappointed! And ive seen posts with other insurances doing that so i was wondering about mine!

Sent from my iPhone using the BariatricPal App

I have been denied twice. The approving insurance kept telling me I need to do more, that I had my co-mormid medical conditions were under control with meds. She had to insert that she was also heavy. That there are so many medical problems.

I pulled a copy of my insurance to check what my requirements were. I compared that with what the denial said is my requirements.

Well guess what? They were different. I contacted my HR dept. They are make calls on my behalf. I should here from them next week.

Don't give up. Let your doctor and your HR dept help you.

You can also file an appeal.

Cocoon to Butterfly

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I was denied a bunch of times with my insurance. I just kept pushing. In the end my letter describing my health issues, family history, ongoing issues because of weight and list of previous weight loss attempts and outcomes, along with my surgeon advocating for me at a peer to peer got me approved.

Just keep fighting. I think they all have to deny at least once.

HW 385 SW 359 CW 335 (50lbs down!) Sleeved 10/5/16

Edited by QueenOfTheTamazons

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I also went through amerihealth caritas and had the same requirements. I was scared I wasn't going to be approved because I didn't lose the 15 lbs my surgeon required before the surgery but I was a approved. Good luck just follow the process and if you are denied your surgeon can work with you to fight it if he determines you are a candidate for the surgery. Good luck!

HW 266 CW 252 surgery: November 14th!

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